Reliability of a questionnaire for diagnosing the severity of temporomandibular disorder

CONTEXTUALIZAÇÃO: Disfunção temporomandibular (DTM) é um termo coletivo que engloba vários problemas clínicos envolvendo a musculatura da mastigação, as articulações temporomandibulares (ATM) e suas estruturas associadas, com alta prevalência nas populações. OBJETIVOS: Sabendo-se que estudos brasileiros vêm utilizando o instrumento proposto por Da Fonseca et al. (1994) para diagnóstico da severidade desta disfunção, realizou-se este estudo com o objetivo de verificar e estimar a consistência interna e a reprodutibilidade do mesmo. MÉTODOS: O delineamento amostral adotado foi o probabilístico, e participaram 1230 indivíduos moradores da cidade de Ribeirão Preto (SP), maiores de 18 anos de idade. As entrevistas foram realizadas por um único entrevistador por meio de ligações telefônicas. Para estudo da consistência interna, calculou-se o Coeficiente de Kuder-Richardson (kr-20) e para estimar a reprodutibilidade, utilizou-se a estatística Kappa (κ). RESULTADOS: A consistência interna do formulário foi de 0,5594, apontando para uma validação abaixo do desejado. Observou-se maior contribuição das questões 1, 2, 3, 6 e 7 para o coeficiente kr-20 total e maior consistência do instrumento quando composto apenas pelas mesmas (0,7044). Observou-se reprodutibilidade "Boa" e "Ótima" para as questões. CONCLUSÕES: Frente ao exposto, sugere-se que o formulário proposto por Da Fonseca et al. (1994) seja adaptado, ficando composto apenas pelas questões 1, 2, 3, 6 e 7 da versão inicial, colaborando, assim, para aumento da confiabilidade do instrumento. Deve-se ressaltar ainda a necessidade da realização de estudos de validade para assegurar adequadas características psicométricas à nova versão do instrumento.BACKGROUND: Temporomandibular disorder (TMD) is a collective term that encompasses many clinical problems involving the masticatory muscles, temporomandibular joints (TMJ) and associated structures and it has high prevalence among populations. OBJECTIVES: Because Brazilian studies have used the instrument proposed by Da Fonseca et al. (1994) to diagnose the severity of TMD, this study was conducted to investigate and estimate the internal consistency and reproducibility of this method. METHODS: We used a probability sampling design to select 1230 participants over the age of 18 years who were living in the city of Ribeirão Preto, SP, Brazil. The interviews were conducted by a single interviewer over the phone. The internal consistency was analyzed by calculating the Kuder-Richardson coefficient (kr-20), and kappa statistics (κ) were used to estimate the reproducibility. RESULTS: The internal consistency of the questionnaire was 0.5594, thus indicating that validation was lower than desired. Questions 1, 2, 3, 6 and 7 had greater contribution towards the total kr-20 coefficient, and the consistency of the instrument was higher when it was composed only of these questions (0.7044). "Good" and "Excellent" reproducibility was observed for these same questions. CONCLUSIONS: Based on these data, it is suggested that the questionnaire proposed by Da Fonseca et al. (1994) should be adapted to include only questions 1, 2, 3, 6 and 7 of the initial version. This would help improve the reliability of the instrument. The need for validation studies must also be emphasized to ensure that the new version of the instrument has adequate psychometric characteristics

Inovações Pedagógicas: das percepções às Práticas Profissionais

It is common to associate the concepts of innovation with technological innovation. Although technological development is one of the key factors that promote innovation, this does not in itself guarantee pedagogical or scientific innovation, for example. Innovation, globally, is distinguished from the concept of reform (concept and practice interconnected with public policies and legislative references), attributed to the broadest level of educational policies. (De)Discourses are thus formed that reconstitute or subvert what is commonly called public opinion. Taking this scenario into account, it is essential to carry out formal studies and assessments on the way in which innovation is understood and practiced by educational actors, seeking to benefit from the clarity of facts and information to the detriment of possible intentional and influential distortions of and in opinion public. We therefore advocate a pedagogical innovation as a significant and lasting change, with an impact on knowledge and pedagogical practices, presupposing several dimensions and a multifaceted and multidimensional character, as they take different forms, which allows us to verify their complexity. In this sense, we assume pedagogical innovation as a set of systematic and deliberate devices and processes, through which the aim is to induce and promote changes in current pedagogical practices, guided by principles and values ​​that legitimize them, providing results and processes of professional teaching practice and practices improvements that require purposeful monitoring to guarantee the quality of the educational service provided. This definition and this reality, as the specialist bibliography shows, implies a revolution in the thinking and action of the school and its agents, as well as the profession of teaching. In this article we will focus on the presentation and discussion of the teaching perceptions of, approximately, more than a hundred primary and secondary education teachers who practice their profession in the north of Portugal, on the concept of pedagogical innovation and its benefits in the quality of the definition of actions, teaching strategies with consequences for learning actions. The methodology used responds to a field study based on a questionnaire survey, from 30 items, considering a Likert-type scale where it was possible to contrast the professional and human situations of teachers in relation to educational changes, educational practices, the design of strategic teaching and learning actions and professional development. The conclusions corroborated the initial hypothesis that pedagogical innovation is an opportunity for professional (and personal) development and that it results from the dilemmas and tensions of the teaching and learning process.Pedagogical innovation can be considered from multiple perspectives by those who can assume themselves as agents of change, acting strategically to innovate their practices at school. In this article we will focus on the presentation and discussion of the teaching perceptions of, approximately, more than a hundred primary and secondary education teachers working in the north of Portugal, on the concept of pedagogical innovation, and its benefits for the quality of the definition of actions and teaching strategies with consequences for learning actions. The methodology used allowed us to contrast the professional and human situations of teachers in relation to educational changes, educational practices, the design of strategic teaching and learning actions, and professional development. The conclusions corroborated the initial hypothesis that pedagogical innovation is an opportunity for professional (and personal) development, and that it results from the dilemmas and tensions of the teaching and learning process.A inovação pedagógica pode ser equacionada a partir de múltiplos olhares, em particular, por aqueles que podem assumir-se como agentes de mudança, agindo estrategicamente para inovar as suas práticas educativas. No presente artigo é nosso objetivo apresentar e discutir as perceções docentes de, sensivelmente, mais de uma centena de docentes do ensino básico e secundário que exercem a sua profissão na zona norte de Portugal, sobre o conceito de inovação pedagógica e os seus benefícios na qualidade da definição de ações estratégias de ensino com consequências na aprendizagem. A metodologia utilizada permitiu contrastar as situações profissionais e humanas dos docentes em relação às mudanças educativas, as práticas educacionais, a conceção de ações estratégicas de ensino e aprendizagem e ao desenvolvimento profissional. As conclusões corroboraram a hipótese inicial de que a inovação pedagógica é uma oportunidade de desenvolvimento profissional (e pessoal), que resulta da complexidade do processo de ensino e aprendizagem.

A new lichen species from the Heritage Range, Ellsworth Mountains, Antarctica

Opegrapha edsonii, with soralia and norstictic acid is described

Research routes on improved sleep bruxism metrics: toward a standardised approach

A recent report from the European Sleep Research Society’s task force “Beyond AHI” discussed an issue that has been a long-term subject of debate – what are the best metrics for obstructive sleep apnoea (OSA) diagnosis and treatment outcome assessments? In a similar way, sleep bruxism (SB) metrics have also been a recurrent issue for >30 years and there is still uncertainty in dentistry regarding their optimisation and clinical relevance. SB can occur alone or with comorbidities such as OSA, gastroesophageal reflux disorder, insomnia, headache, orofacial pain, periodic limb movement, rapid eye movement behaviour disorder, and sleep epilepsy. Classically, the diagnosis of SB is based on the patient’s dental and medical history and clinical manifestations; electromyography is used in research and for complex cases. The emergence of new technologies, such as sensors and artificial intelligence, has opened new opportunities. The main objective of the present review is to stimulate the creation of a collaborative taskforce on SB metrics. Several examples are available in sleep medicine. The development of more homogenised metrics could improve the accuracy and refinement of SB assessment, while moving forward toward a personalised approach. It is time to develop SB metrics that are relevant to clinical outcomes and benefit patients who suffer from one or more possible negative consequences of SB. © 2021 European Sleep Research Societ